Who Is Not Eligible For Smile Surgery?

People suffering from nearsightedness prefer laser surgery because they only know it is the only option. But there are other advanced methods of treating these issues. One of the treatments that further develop the Femto-LASIK procedure is SMILE or ReLEx SMILE(Refractive Lenticule, Small Incision Lenticule Extraction). This surgery is a gentle correction of ametropia. This surgery is equipped with femtosecond technology with a very high precision lenticular extraction. This surgery is conducted bladeless. SMILE surgery helps in correcting deformities such as short-sightedness and astigmatism. Also, other traditional methods are available to treat these problems, but many eye specialists prefer SMILE surgery because of its excellent advantages.

SMILE surgery is performed by using a VisuMax femtosecond laser. It is recognized worldwide as Carl Zeiss Meditec is the creator of this technology. The surgeon performing this surgery uses this laser to create a tiny lens-shaped bit of tissue(lenticule) within the cornea. After that, a small arc-shaped incision is made on the surface of the cornea, and then a surgeon extracts the lenticule through this incision and then discards it. This surgery is known to correct upto 10.00 diopters of nearsightedness.


Are you eligible for SMILE surgery?

There are some applicable requirements that one should meet to be eligible for SMILE surgery. Some of these requirements are mentioned below:

  1. Candidates who prefer a SMILE surgery must be affected by one of the common types of refractive errors, such as short-sighted astigmatism or short-sightedness.
  2. Candidates should not be suffering from any kind of disease, ocular in general, as these can affect the surgery or the ability of the patient to heal quickly and correctly. Generally, the candidate should be in good health.
  3. The candidate should be at least age 21 or older. They should have had a contact lens prescription or stable glasses, at least for the past two years.

Some requirements can affect the surgery and make a candidate ineligible for the SMILE surgery, as, in some cases, there can be some complications or risks involved. Make sure you are also thorough with your eye history so that you can discuss with the surgeon their eye history for the expected results and benefits. It is also crucial for the surgeon to know these details as they will perform effective procedures on your eye. Some of these requirements are mentioned below:

  1. Candidates with significant scarring of the cornea.
  2. Candidates who are breastfeeding or pregnant are advised to delay the procedure for some time.
  3. Candidates who are going through some special treatment such as immuno-suppressants and steroids. Medications like these can render the immuno-compromised, adversely affecting the healing process.
  4. People suffering from autoimmune, uncontrolled diabetes, slow healing, and collagen vascular disorders are not eligible for SMILE surgery.
  5. People are suffering from certain eye viruses like herpes zoster and herpes simplex.
  6. People with specific eye problems or a history of eye problems like strabismus(muscle imbalance), severe dry eyes, amblyopia (lazy eye), previous eye injury, previous eye surgery, or any active eye conditions or recurrent, residual eye conditions. Other conditions you must discuss with your surgeon include back problems, claustrophobia, keloid scarring from previous surgical healing, and other psychological problems that can affect the patient after surgery.


Why prefer SMILE?

SMILE surgery is preferred over tha traditional LASIK surgery for so many reasons; some of these reasons are mentioned below:

  1. SMILE surgery can treat short-sighted patients to upto ten diopters, while LASIK surgery is only recommended for patients with refraction upto a maximum of -8 diopters.
  2. While performing SMILE surgery, an opening of as small as 4mm is made to treat the cornea, while in LASIK surgery, a huge opening is made to reshape the cornea.
  3. SMILE surgery uses advanced technology, such as a keyhole which is a suitable option for people with dry eyes. This helps keep the corneas stable and has no disturbance in the flow of tears. LASIK is known for generating more tears.
  4. SMILE surgery uses a minimal procedure that does not require flap folding, while in LASIK surgery, there is cutting a flap and then folding it backward to remove the corneal tissues.
  5. SMILE surgery uses a high-reputation worldwide technology which is 100% femtosecond technology. This method is also considered the safest and the most precise method of correcting visual disorders, while LASIK surgery uses the traditional method.

SMILE surgery suits patients with dry eyes, thinner corneas, or higher ametropia. The procedures in SMILE surgery remain fully intact with a thinner cornea minimum of 480 micrometers as the tissue ablation does not go as deep. In traditional LASIK surgery, to regulate the tear film, the nerves in the upper corneal layer are retained to reduce the risk of dry eyes after the operation. With SMILE surgery, there is no strong feeling of a foreign body on the cornea-felt the eye, while in LASIK surgery, the treatment takes place inside the eye. The central concept behind SMILE surgery is to make the current laser procedure more stable, reliable, and long-term. SMILE surgery is free from all flap-related complications, which can be possible in other forms of LASIK. The cornea after the SMILE surgery is considered more stable as the incision made on the cornea is 80% smaller than the flap cut made during traditional LASIK surgery, also minimizing the chances of any corneal thinning and ectasia and dry eye.

The SMILE indication for myopia and astigmatism is for sphere – 0.50 to 10.00 D, for cylinder – 0 to 5.00 D, and spherical equivalent – 0.50 to -12.50 D. After the SMILE surgery, 88% of people had a visual acuity of 20/20 or better. People have also stated less induction of optical aberrations after the SMILE surgery. The procedure behind the SMILE surgery is also fundamental first, the creation of the lenticule and the incision. In this step, an incision of 2 mm is created on the cornea to create the refractive lenticule. Then the lenticule is removed from the incision, and the cornea remains stable and undisrupted. This changes the shape of the cornea, thus achieving the desired correction as it will now change how light will bend into the eyes. This will allow the patient to see once again.


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